Author Archives: Tom Bouthillet

Here’s a great story from WSFB-TV Channel 3 Eyewitness News (Hartford-New Haven) featuring our very own Peter Canning from the Street Watch: Notes of a Paramedic blog! Watch as Peter calls in a “definite STEMI Alert” and activates the cath lab! Click HERE for the best quality video without commercials. Screen shots below.

Some of you are probably wondering whether or not I’d ever condone giving a calcium channel blocker to a wide complex tachycardia in the field. A recent case submitted by Robert Bees demonstrates a situation where I might consider it (or at least not criticize someone for considering it). EMS is called to a 90 […]

I received an email today from a reader who ripped me a new one. Here’s the email with my replies interspersed. To Whom This May Concern, I stumbled upon this site while looking for additional information on poor r-wave progression. I happened to notice that in the wide-complex tachycardia section, there were some errors […]

Here is the conclusion to 72 year old male CC: Unknown problem (man down) Here was the initial 12-lead ECG. Based on this ECG the lead paramedic called a "STEMI Alert" and transmitted the ECG to the receiving hospital. The on-duty ED physician received the ECG and the paramedic's radio report. The ED physician […]

The International Association of Fire Chiefs is accepting nominations for the Heart Safe Community PAD Program & STEMI Awareness Community Program Awards. Follow the IAFC on Twitter. Become a fan on Facebook. Note: You do not have to be a fire-based EMS system to win one of these awards!

Here’s another great case submitted by a faithful reader who wishes to remain anonymous. The patient is a 64 year old male with a chief complaint of substernal chest pain. Onset: Sudden onset at rest. Provoke: Nothing makes the pain better or worse.Quality: Patient describes the pain as “sharp”.Radiate: Pain radiates to right arm.Severity: Patient […]

EMS is dispatched to a 72 year old male patient. Third party call. History of Parkinson's Disease. Patient is conscious. No further information. On arrival, EMS finds a 72 year old Spanish-speaking male. Through an interpreter the lead paramedic determines that the patient became dizzy, fell down, and hit his head. A small hematoma is […]

Occasionally I receive emails from readers who ask various questions or submit interesting ECGs which I sometimes use as case studies on the Prehospital 12-Lead ECG blog. Back in November I received an email from a reader who wrote: Hello! I’m currently in Antarctica on a medical support contract. I was issued a 3-lead Lifepak […]

I am now registered to attend EMS Today. Who else is going? http://c.brightcove.com/services/viewer/federated_f9/22978752001?isVid=1&publisherID=22899959001 *** Update 02/05/2010 *** I found out yesterday that Justin Schorr (The Happy Medic) and Mark Glencorse (999 Medic) will be attending the EMS Today Conference through the Chronicles of EMS project! The Happy Medic writes about it HERE. 999 Medic writes […]

A faithful reader (and movie star) brought an interesting PSA to my attention. It’s a Heart Health Awareness video from Denver Health. The video is interesting because it shows a heart attack and associated cardiac arrest from a patient’s perspective, including all phases of care. First, the patient is struggling as he walks down the […]

Ken Grauer58 Year Old Male, Workout Worry@ Eli — I don’t see AFlutter. That is, I see no indication of regular atrial activity at a rate consistent with AFlutter. Instead, the rhythm is irregularly irregular without P waves = AFib at a controlled ventricular response. In my opinion, one doesn’t need Sgarbossa criteria here to activate the cath lab. So, yes the…
2018-09-13 02:09:24

Vince DiGiulioIs epinephrine harmful in cardiogenic shock?Sorry about that; I copied the quote from the article and my browser automatically changed the "μ" to an "m". Thanks for noticing, and thanks for pointing it out in the most passive-aggressive manner possible.
2018-09-12 16:45:26

Ken Grauer, MDElectrocardiographically Silent High Lateral STEMI EquivalentHi Tom. This is a great case — so NICE that you posted it for others to learned from. But as I commented several times when you sent this case around to our group — the T waves in V2,V3 are disproportionately peaked and transition occurs early (between V1-to-V2) — so the chest leads are NOT…
2018-08-14 08:38:03

Eli58 Year Old Male, Workout WorryAnybody else see the possibility of a LBBB or A-Flutter? I'm not sure if this will make any difference with the treatments but im just trying to interpret it first because if there is a LBBB then it does not meat Sgarbossa criteria and if it is A-Flutter that could explain the hyper acute T's…
2018-07-20 21:29:21